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CONTEXT Currently most automated methods to identify patient safety occurrences rely on administrative data codes; however, free-text searches of electronic medical records could represent an additional surveillance approach. OBJECTIVE To evaluate a natural language processing search-approach to identify postoperative surgical complications within a(More)
BACKGROUND Previous studies have suggested that older women may be more likely than older men to receive potentially inappropriate prescriptions. A better understanding of sex differences in inappropriate prescribing can help inform the development of effective interventions. OBJECTIVE This study was conducted to assess sex differences in rates of(More)
BACKGROUND Many studies have identified patient characteristics associated with potentially inappropriate prescribing in the elderly (PIPE), however, little attention has been directed toward how health care system factors such as geriatric care may affect this patient safety issue. OBJECTIVE This study examines the association between geriatric care and(More)
An empirically derived risk adjustment model is useful in distinguishing among facilities in their quality of care. We used Veterans Affairs (VA) administrative databases to develop and validate a risk adjustment model to predict decline in functional status, an important outcome measure in long-term care, among patients residing in VA long-term care(More)
PURPOSE The objective of this study was to compare gender differences in mental health disease burden and outpatient mental health utilization among veterans utilizing Veterans Health Administration (VHA) mental health services in fiscal year 1999 (FY99), after the first Gulf War and significant restructuring of VHA services. METHODS We used logistic(More)
BACKGROUND Although difficulties in applying risk-adjustment measures to mental health populations are increasingly evident, a model designed specifically for patients with psychiatric disorders has never been developed. OBJECTIVE Our objective was to develop and validate a case-mix classification system, the "PsyCMS," for predicting concurrent and future(More)
BACKGROUND The Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs) use administrative data to detect potentially preventable in-hospital adverse events. However, few studies have determined how accurately the PSIs identify true safety events. OBJECTIVES We examined the criterion validity, specifically the positive predictive(More)
BACKGROUND The Centers for Medicare and Medicaid Services' (CMS) all-cause readmission measure and the 3M Health Information System Division Potentially Preventable Readmissions (PPR) measure are both used for public reporting. These 2 methods have not been directly compared in terms of how they identify high-performing and low-performing hospitals. (More)
Risk adjustment for mental health care is important for making meaningful comparisons of provider, program, and system performance. The purpose of this study was to compare the predictive value of three diagnosis-based risk-adjustment models for predicting self-reported mental health outcomes. Baseline and 3-month follow-up mental health assessments were(More)
BACKGROUND The Patient Safety Indicators (PSIs) use administrative data to screen for select adverse events (AEs). In this study, VA Surgical Quality Improvement Program (VASQIP) chart review data were used as the gold standard to measure the criterion validity of 5 surgical PSIs. Independent chart review was also used to determine reasons for PSI errors.(More)